French doctor speaks out in pollution controversy

Domhnall MacAuley is a CMAJ Associate Editor and professor of primary care in Northern Ireland, UK

CMAJ and other medical journals have called for medical leadership on climate change and related issues. Kirsten Patrick’s recent editorial addresses physicians responsibility as agents for change. But what happens if you do speak out? Dr. Frédéric Champly, chief of the emergency department in Sallanches hospital, which serves the Chamonix valley and the local region of the French Alps, recently drew attention to pollution by particles and mono nitrogen oxides in the Arve valley. Although we may be concerned yet unsurprised at pollution in industrial cities, this river valley in a beautiful alpine landscape is the gateway to major winter sports centres, a climbing and walking paradise, and is overlooked by Mont Blanc. It also contains the Autoroute Blanche (A40) leading to the Mont Blanc tunnel. Medical colleagues locally had already raised their concerns.

When Dr. Champly was interviewed on television, he described the effect of this pollution on patients attending his hospital, his concern for those exercising in this environment, his worries about the local children and, on a personal note, that he kept his children away from school at times when the pollution level was highest. He was then criticized publicly by a local politician, Jean Marc Peillex, mayor of the commune of St Gervais who did not feel there should be public debate and who asked the Regional Health Agency to sanction Dr. Champly. In response, 220 of Dr. Champly’s medical colleagues in Haute Savoie signed a letter of support and sent it to the French President, outlining the severity of the problem, their indignation at the reaction of the authorities and the ineffectiveness of any measures already taken. To learn more about how this story has evolved, take a look at the Facebook page created in his support, which contains some remarkable photographs, maps and diagrams indicating the level of pollution, in addition to television interviews and news stories from the local newspaper. The page also contains a copy of his colleagues’ letter of support with additional online signatories. The evolution of this story shows just what can happen if doctors take a stand, together with the remarkable power of social media and its potential to facilitate change.

Pollution is, of course, a complex and politically sensitive issue; in this case, it has implications for tourism, local industry, transport, individual behaviour and the local tradition of wood-burning fires. No wonder it is such a difficult issue for local politicians. However, pollution continues to be a major problem in France; just this week, the entire northern part of the country was covered by a cloud of pollution. Evening news bulletins showed pollution maps as an integral part of their weather forecasts. Paris was shrouded in smog, and some regions introduced severe speed restrictions. As has happened in the past, Paris introduced “circulation alternée” on Monday, in which traffic is restricted by number plates. Only vehicles with odd-numbered plates were allowed to drive, and public transit was free.

France gasped this week, but the story from Haute Savoie shows how doctors can raise awareness. Perhaps we need more Dr. Champlys.